Mitigating the effects of stumble perturbations in transfemoral amputees

项目摘要 跌倒和由福尔斯跌倒引起的损伤在经股截肢者中普遍存在， 由于当前假体介入的缺陷而易受这种福尔斯的影响。本研究的目的是： 1)更好地了解导致截肢者福尔斯跌倒的因素，2）调查活动的可能性， 假肢中的反射行为将降低绊倒扰动导致跌倒的可能性。 具体来说，这项研究将：1）实验表征的可能性，绊倒扰动将导致 当使用典型的日常使用的膝关节假体时，经股截肢者人群的下降; 2）表征 当膝关节假体被赋予拉伸时，绊倒扰动将导致跌倒的可能性- 反射型行为;以及3）描述当跌倒时，绊倒扰动将导致跌倒的可能性。 膝关节假体具有绊倒-恢复-反射型行为。第一项研究将提供重要 关于经股截肢者对绊倒扰动的敏感性的数据，并将使 研究界将注意力集中在最高易感性的区域（即，步态阶段的部分 在此期间，绊倒扰动最有可能导致下降）。侧重于 最高的易感性可能会导致更有针对性和更有效的干预措施，以减少 跌跌撞撞的扰动导致福尔斯下跌的可能性。第二项和第三项研究将调查 两种此类干预措施，以减轻该人群的福尔斯跌倒，并将其疗效与基线研究进行比较。 本文所述的研究结果可能对减少经股截肢者福尔斯跌倒产生重大影响， 因此可以大大改善这一人群的健康和生活质量。

Project Summary Falling and injuries resulting from falls are pervasive among transfemoral amputees, who are particularly susceptible to such falls due to deficiencies in current prosthetic interventions. The purpose of this study is to: 1) better understand the factors that lead to falls in amputees, and 2) investigate the potential that active reflexive behaviors in a prosthesis will decrease the likelihood that stumble perturbations will result in a fall. Specifically, this study will: 1) experimentally characterize the likelihood that stumble perturbations will result in a fall in the transfemoral amputee population when using typical daily-use knee prostheses; 2) characterize the likelihood that stumble perturbations will result in a fall when the knee prosthesis is endowed with a stretch- reflex-type behavior; and 3) characterize the likelihood that stumble perturbations will result in a fall when the knee prosthesis is endowed with a stumble-recovery-reflex-type behavior. The first study will provide important data regarding the susceptibility of transfemoral amputees to stumble perturbations, and will enable the research community to focus attention on the regions of highest susceptibility (i.e., the portions of gait phase during which a stumble perturbation is most likely to result in a fall) in this population. Focusing on regions of highest susceptibility will presumably result in more targeted and effective interventions for reducing the likelihood that stumble perturbations result in falls. The second and third studies will investigate the potential of two such interventions to mitigate falls in this population, and will compare their efficacy to the baseline study. The results of the study described here could have a substantial impact in reducing transfemoral amputee falls, and as a result could substantially improve health and quality of life of this population.